Estrogen Dominance: What You Should Know

Estrogen Dominance: What You Should Know

Here at Proov, we are all about hormones. Since we tend to focus on progesterone (what can we say, it’s our favorite!), today we wanted to dive into the yin to progesterone’s yang: estrogen.

Just like progesterone, estrogen levels can easily be thrown out of whack in a common hormone struggle called estrogen dominance. Being aware of your hormones and potential imbalances can help you live your best life!

Let’s review: Why is estrogen so important?

During the first half of your cycle, estrogen is produced by the ovaries. Estrogen regulates your cycle and controls the growth of the uterine lining before ovulation. Like other hormones, estrogen plays roles in parts of the body other than just the reproductive system. Estrogen is responsible for increased energy, bone formation, and heightened awareness.

What is estrogen dominance?

Estrogen dominance occurs when estrogen levels are abnormally high in relation to progesterone. This doesn’t necessarily mean that progesterone levels are normal and estrogen levels are higher; sometimes abnormally low progesterone levels can cause estrogen dominance. 

Estrogen dominance can be caused by several different factors. The first is excess fat cells. Fat cells produce and store estrogen. So, the more fat cells a woman has, the more estrogen she makes.  

Estrogen can also rise in response to some medications, including hormonal birth control and estrogen replacement therapy which can be a treatment for menopause. 

Estrogen dominance is also commonly linked with PCOS. Because of an excess amount of androgens, women with PCOS often experience a hormone imbalance that prevents ovulation from occurring (a.k.a. anovulation). When ovulation doesn’t occur there isn’t an empty follicle to produce progesterone. This leads to an excessive amount of estrogen in comparison to little or no progesterone. 

Estrogen dominance PCOS symptoms are different in every woman. Some common signs of estrogen dominance PCOS:

  • Irregular periods
  • Spotting
  • Heavy periods
  • PMS
  • Bloating
  • Difficulty sleeping
  • Fatigue
  • Low libido
  • Swollen or tender breasts
  • Uterine fibroids

Estrogen dominance and fertility

So, how does estrogen dominance affect fertility? Estrogen dominance can be a sign of (or cause) anovulatory cycles. For women with PCOS, estrogen dominance doesn’t cause anovulatory cycles (remember that they are caused by excess androgens) but without ovulation, no progesterone is produced. This could lead to an excess amount of estrogen in relation to progesterone. Estrogen dominance in these women can indicate ovulation may not be occurring. 

Women who carry excess fat cells may experience anovulation as excess estrogen levels can act as a “natural” birth control, preventing ovulation from occurring. 

Regardless of the cause of an anovulatory cycle, without an egg there is no chance at conception, meaning that women with estrogen dominance could have trouble conceiving. 

If I think I have estrogen dominance what should I do?

Since estrogen dominance is common among women there are many ways to identify and treat it. If you’re trying to conceive and suspect you may have estrogen dominance, confirming ovulation may provide some peace of mind knowing that ovulation is in fact occurring.

Proov is the first and only FDA cleared PdG test kit to confirm ovulation at home. PdG is the urine metabolite of progesterone and is only metabolized in urine when progesterone is present in blood. A presence of PdG in urine confirms ovulation. 

Proov testing protocol recommends testing on days 7, 8, 9, and 10 after suspected ovulation (always using first morning urine, of course!). While a single positive Proov test confirms ovulation, four positive tests during the testing window confirm “successful” ovulation, meaning that ovulation was healthy and gave the best chance at possible conception. 

If you never get a positive Proov test, this could be evidence of anovulatory cycles. In this case, we recommend consulting your doctor. If one or more of your Proov tests is negative or slightly negative, this could be a sign of “weak” ovulation and low hormone levels. You can learn about ways to naturally increase PdG here. Regardless, negative Proov results during the testing window can be a sign of an ovulatory problem that could make it difficult to successfully conceive. We recommend consulting your doctor, who will be able to do additional hormone testing.

Have other questions about estrogen dominance? Reach out to us at!